### TRANSMITTA Lo f OMAH ALEA D SIT E SOI LREMEDL\TIO NFIL EFOLDE R SAID# : !^;)fi\( Q I Date : Address : 1^ 4 H ) \i . ^.^ ^ 6 T Remediatio nContractor : Envrionmenta l Restoration , LLC

_Year : _201 0 SOI LREMEDIATIO N PROPERT Y FIL EFOLDE RDOCUMENT S D Vide o o f property (DVD ) JSBefor e D After 5 1 Basemen t D ^ Executiv e Summary (Fina l Report )

Q EPA-provide dproperty sketc h ^ Signe dAcces s Agreemen t fo r subjec t property D Signe dAcces s Agreement(s ) fo r adjacen t property ^ 

### Restoratio nAgreemen t D Settlemen t document s (i.e. , fo r damag e or t o replac e plants , etc. ) ^ Confirmatio ndat a

D Photograph s _S Before DCre w Photo s D Durin g Excavatio nB . So d \ l 30-day So dD

• v ^ As-buil t sketc h ^ ^ Completio nAgreemen t signe db y Property Owne r ^ Property close-ou t chec k lis t signe dby EP A D Descriptio no f area s no t meetin g RO D cleanu p criteri a ^ Utility clearance s

H

^ Property informatio nfromDougla s County Assessor' s Offic e NProperty acces s checklis t H ] Contac t Lo g 

# n Environmenta l Restoratio nSignatur e Dat e



# yO/lx"X ^ ^-Z7,^i ( 'EP ACO Rsignatur e X Date

## \ Omah a Lea d Site—EP-R7-09-0 5 8 Environmertta l Restoration . LL C jfwww.er1lc.co m 

# EXECUTIV ESUMMARY : 32961-381 8 N 2 2 S T 

# fx l No Issue s o r Concern s [ ^ Issues/Concern s Detail Explanation :

# -EP A EP APropert y Clos e Ou t For m Omah aLea dSit e Propert y # : 

## 'S'^Ui ) Propert y Address : yT^)* ^ 

## Vj . 9.-3 1 S T Date/Time : Owner' s Name : l-oJk'€.^ U 

## U O 

# ^^ U Quad s Excavated : ^\. ^ 3 k

.9> \ ;ntW l R Contracto r Grou p : Environment s Restoratio n(ER ) Excavatio nGenera l Ye s N o i . If necessary , were th e correc t quadrant(s ) excavate dan drestored ? 

### - U l 2 . If necessary , were th e correc t area s o f dri p zon e excavate dan drestored ? i X Gradin g So dan dVegetatio n Ye s N o 1 . Doe s th e gradin g aroun dth e perimete r o f th e hous e inexcavate darea s generall y slop e away fromth e ^ house ? ^ 2 . Ha s so dbeenlai di nal l area s that were excavated ? e^j/Xtit r Q* ^ drvJt^ J /lt^ < ObCca^lfncXitt ^ 3 . Doe s th e so dappear to b e generall y health y an dgrowing ? (Onl y evaluat e if insjfecte dat JO-da y tim e period) . 4 . Are sodde darea s generall y firman devenl y graded ? t ^ 5 . Are th e joint s betwee nth e so dstrip s generall y tight ? (Onl y evaluat e if inspecte da t 30-day tim e period) . 6 . Wa s th e property grade dsuc hthat wate r will no t poo l o nth e property ? ^ 7 . Wa s damag e to landscapin g o r plan t material s avoided ? i ^ Gates , Fence s an dRetainin g Wall s Ye s No 1 . D o gate s ope nandclos e freely? (i f applicable ) 2 . Were al l gate s o r fence s take ndow ndurin g restoratio nactivities re-installed ? (i f applicable ) 

# yA ­ 3 . Wa s damag e to gate s o r fence s avoided ? (i f applicable ) 4 . Wa s damag e to retainin g wall s avoided ? (i f applicable ) Foundation , Sidin g an dGutter s Ye s N o 1 . Wa s damag e t o sidin g o r tri mavoided ? ^ 2 . Wa s damag e to th e foundatio navoided ? L ^ 3 . Wa s damag e to windows avoided ? • ^ fc*^ 4 . Wa s damag e t o windo w screen s o r doo r screen s avoided ? 5 . Wa s damag e t o downspout s o r downspou t extension s avoided ? ^ i - Sidewalk s an dDriveway s (Concrete ) 1 . Wa s damag e to driveway surface s avoided ? 2 . Wa s damag e to walkway surface s avoided ? Inspectio nnotes : Ye s 

## Ai^ A

L ^ No



### Remedia l an drestoratio nactivitie s complet e includin g 30-da y so dwarranty : EP ARepresentati v Date :

### Pag e 1 of 2
"> [ Creat e Anothe rTicke t ~] [ Bac k t o Irt h Interne t ] Sen d Emai l



### • YOU RTICKE T NUMBE RI S 255958 0 Origina l Cal l Date : 8/04/1 0 Time : 6:5 5 am Op : TRACY2418 6 Wor k t o Begi n Date : 8/06/lO f Time : 7:1 5 art f State : N E County : DOUGLA S Place : OMAH A Address : 381 8 Street : N22ND S T Twp : 15 NRng : 13 E Sect-Qtr : 03-S W Twp : Rng : Sect-Qtr : Lega l Given : C Typ e o f Work : Excavatin g th e entir e propert y Locatio n o f Work : LOCAT E ENTIR E PROPERT Y Remarks : FA X AL L CLEAR S TO : ( 4 02)451-106 9 : SAI D #3296 1 f Compan y ENVIRONMENTA L RESTORATIO N Contac t Nam e TRAC Y BRISTO W Phone : (402)451-131 4 Alt . Contac t Phone : (314)504-487 4 Wor k Bein g Don e For : EP A Dept h o f Excavation : 12 " Corne r Lot : NFront : Y Rear ; Involve s Tunnelin g o r Horizonta l Borin g : NExplosives : N ALT87 2 CXCAT V MUDO l OMAHACO F 0PPDGPR 5 QLNNEI C Servic e Are a Contac t Phon e Numbe r Utilit y Typ e 

### Day : 406728934 3 ALT87 2 WINDSTREA M COMMUNICATIO N EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3 

### Day : 402934046 9 CXCAT V CO X COMMUNICATIONS , IN C HEID I 

### Alt : 402934046 9 Emerg : 402932975 7 Day : 402504782 3 MUDO l METROPOLITA NUTILITIE S DISTRIC T SAND Y 

### Alt : Emerg : 402504797 0 Day : 402444719 7 OMAHACO FCIT Y O FOMAHA-TRAFFIC,SEWE R RICH/TRAFFI C Alt : 402444516 1 Emerg : 402444516 0 

### http://www.dhon.org/irthintemet/DHONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 8/4/201 0

### Pag e 2 of 2

OPPDGPR 5 OMAH APUBLI C POWE RDISTRIC T Day :

EL M LOCATIN GAlt : 406728934 3 406207149 4 Emerg : 888728934 3 QLNNEI C QWES T LOCA LNETWOR K Day : 406728934 3

EL M LOCATIN GAlt : 406207149 4 Emerg : 888728934 3

http://www.dhon.org/irtliintemet^HONNoticeCreation/MessageText.asp?ret=<RESULTS. . . 8/4/201 0

## Contac t Snformatio n Lo g SAiD # 371 0 J
Owner' s Nam e 

### •^

= jjCrro U U^ri^Usc f I Daytim e Phone : ^^-^Jl ^ C r^o ^

^V ^ Propert y Address : J8l & AJ » tZ 

# 76 7 Attemp t t o contac t Date/tim e Nam e 

# ^/cs/u*< > l^lc M /i^ ^ o'^H o \oJ(\ K ^if^MU t 

## (i^'I O -1 0 

# p i 'ux ^ 

# 9^ ^ 

# I'/ o 

# 3 ? o 

# /B .

# Propert y Acces s Checkiis t ISAID : 3J2^ ^ / — 1 n WORKCOMPELTE D ON : Owner : /^-fr^/ f UJ^/gCflS ^ Renter ; Address : 

# /^6 ^

P-o^XXe^^XP r Phone: Stji f .%Z. ^ ^^ ^ Fax :

Additiona l Vide o o r Digita l Photo' s Taken : nVide o n Digita l Phot o O n : / / 

## By : 1 Reason : j nVide o n Digita l Phot o O n : / / By : 1 Reason :

nVide o n Digita l Phot o O n : / / By : Reason : • [ nVide o n Digita l Phot o O n : / / By : Reason : _— .

Omah a Lea d Projec t Wor k

Pla n Pag e 1 o f 1 9

## Consen t fo rAcces s to Propert y 

## SASD # RIGH T OFENTR YTO PREMISE S , 

### Granto r (th e property owner) , consent s to an dauthorize s th e Unite dState s Environmenta l Protectio nAgenc y (USEPA ) or it s authorize drepresentatives , collectivel y th e Grante e to ente r an dperfor mcertai nenvironmenta l respons e activitie s upo nth e followin g describe dpremises, : I Owner' s Name : /^cfft K l/Jj/ZaLisj / \'^^^^^^^''^^^^
- ^t~H^'Zl N\ Addres s 

# '' 3?>l ^ /V^2 ^ Address : Addresse s of Propertie s Address : covere d by thi s Agreement : Address : 

### Address : PURPOS E OFINVESTIGATIO N 

### Th e purpos e of th e remedia l activitie s is to remov e al l soil s at th e propert y whic hare contaminate dwit hhazardou s substances , inparticula r lea d at concentration s greate r than.o r equal to 40 0 part s pe r millio n(ppm) . REMEDIA L ACTION S 

### Th e environmenta l respons e action s to be performe d onsai dpropert y ma y includ e the followin g activities : a.Takin g photograph s and/o r vide o of the.propert y before , during , an dafte r remedia l activities ; b.

Locatin g equipmen t an dmachinery on-sit einpreparatio nfo r an d inth e cours e of th e environmenta l response ; c.

Plannin g an dimplementin g th e remova l actio n on or near Grantor' s property . d.Obtainin g sample s fi-om Grantor' s property ; AGREEMEN T NO T To INTERFER E Tli e Granto r agree s no t to interfere or tampe r wit han yof th e activitie s or wor k done , or th e equipmen t use d to perfor mth e activities , or to undertak e an y action s regardin g th e Use of sai d propert y whic hwoul dten d to endange r th e healt h or welfare of th e Grantee s or th e environment , or to allo w other s to us e th e property insuc h ^ 

### I gram t acces s to my propertie s nI do EO t gran t acces s to my propertie s 

# /y ^ D.Zi A {,-10-1 0 Signatur e Dat e Signatur e Dat e

### Additiona l Comment s / Instructions :



### LO01/^ 1 c j ljl<~ e /Aif<^''< ^

p<"oW^s > TiA^ken r

• Chec k thi s boxi fowne rdoe s no t wan t E.R . t o ente rth e resident s t o documen t interio r foundatio n wall s an d possibl e preexistin g damage . Bycheckin g thi s bo xE.R . i s no t responsibl e fo ran ydamag e don e t o th e interio ro fhouse , includin g foundatio n crack s o rfissures .

I agre e [ H I d o no t agre e 

# • 

# la g re e C H I d o mo t agre e ^



### Owner' s Signatur e Contractor' s Signatur e Date

## Restoratio n Agreemen t Th e purpos e o f thi s agreemen t i s t o provid e amutual agreemen t a s t o condition s o f propert y prio r t o contracto r activities . Thi s wil l als o serv e a s documentatio nfo r th e purpos e o f assurin g tha t restoratio n activitie s ar e complete dt o th e satisfactio no f th e propert y owne r an dth e Unite dState s Environmenta l Protectio nAgenc y (EPA) .

Propert y Address : 5^/ ^ / J SQ . ^ Owner : l^4f^^ f JAJricfl^h^/J O nth e attache ddiagram(s ) indicat e area(s ) to b e excavate dan ddeptho f excavation , locatio no f al l know n utilities , subsurfac e features , surfac e structure s an dlandscapin g features , acces s location(s ) t o b e use db y contractor , an dth e directio no f North . Indicat e distances , depths , materia l types , etc . Indicat e digita l photo s b y referencin g th e photo-lo g numbe r witha narro w indicatin g directio no f view . Stem s t o b e remove d b yCorjtracto ran d no t replaced : 

## U ^ ( C^J/aJ ^

U)\ ^ 9QJ .

Pag e 1 o f2

### Additiona l Comment s / Instructions :



# ¥• I agre e D I d o no t agre e Q I agre e • I d o no t agre e

Owner' s Signatur e Contractor' s Signatur e Attachment s

Pag e 2 o f2' ""~"i~"-. # _ —...|—.., —- -^ , - 

### Thi s agreemen t document s th e completiono f remedial activitie s performe do nm y property . M y signatur e wil l designate tha t I a msatisfie dwit hth e restoratio no f m y property , an dtha t n o item s ar e i n question , now , o r a

t an y tim e i nth e future , excep t thos e item s liste dbelow , i f any . 

# s^^p
- 

# 3^^ n Propert y Address : 3^/ ^ K Z2 ^ ^ Owner : /^jy ^ K lOri't^LfsJ / Restoratio nItem s I nQuestion :

Additiona l Commsnts ; 

# '7Z ~ I agre e restoratio ni s completed , except a s noted |\1 1 agre e restoratio nis completed , excep t as noted \v \I agre ( I I I d o no t agre e restoratio ni s complete d I I I d o no t agre e restoratio nE S complete d 

# »K^ ^ yX-/ d{:?£/)A^ £Y'^¥-A Owner' s Sfenatur e 

### Date CoKtractor' s Signatur e Bat e

### Dougla s County Accoun t Informatio n Pag e 1 of 3 Dougla s County , Nebrask a Propert yRecor d - R201404000 0 Prin t Repor t NE WFeatur e - Parce l Dimension s availabl e @ scal e 0-5 0 f t wes t o f52n d S t - ViewO n Ma p Informatio n i s vali d a s o f2009-12-3 1 Treasurer' s Ta xRepor t Ne wFeatur e ->->- > Aut o Sale s Searc h Owne r WRIGHTSEL L INVESTMENT S LL C C/ 0 LATREL L WRIGHTSEL L 1265 7 DEE R CREE KD R OMAH AN E 68142-000 0 Propert yInformatio n Ke yNumber : Accoun t Type : Parce l Number : Parce l Address : Lega l Description : Valu e Informatio n Lan d 200 9 200 8 200 7 200 6 200 5 200 4 Sale s Informatio n Sale s Date : Dee d Type : Price : Grantor : Grantee : Valid/Invalid : Exclusio n Reason : Sale s Date : Dee d Type : Price : Grantor : 140 4 000 0 2 0 Residentia l 201404000 0 381 8 N 2 2 S T OMAH AN E 68110-000 0 PLAINVIE WLO T4 BLOC K6 S 2 5 FT2 5 X 12 4 Improvemen t Tota l $7,000.0 0 $28,900.0 0 $35,900.0 0 $7,000.0 0 $28,900.0 0 $35,900.0 0 $7,000.0 0 $28,900.0 0 $35,900.0 0 $7,000.0 0 $28,900.0 0 $35,900.0 0 $7,000.0 0 $5,800.0 0 $12,800.0 0 $7,000.0 0 $5,300.0 0 $12,300.0 0

2006-01-2 3 QC M Book : 200 6 Page : 00779 6 $0.0 0 Latrel l Wrightsel l eta l Wrightsel l Investment s Invali d Famil ySal e 2006-01-1 1 W D Book : 200 6 Page : 00453 7 $0.0 0 GILBER TL CAI N 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20. . . 1/18/201 0

### Dougla s County Accoun t Informatio n Pag e 2 o f 3
Grantee : LATREL L WRIGHTSEL L ETA L Valid/Invalid : Invali d Exclusio n Reason : Correctiv e Dee d Sale s Date : 2006-01-0 9 Dee d Type : QC M Book : 200 6 Page : 00269 4 Price : $0.0 0 Grantor : Wrightsel l Investment s Grantee : Latrel l Wrightsel l eta l Valid/Invalid : Invali d Exclusio n Reason : Correctiv e Dee d Lan d Informatio n Acre s S F Unit s Dept h Widt h Vacan t 0.0 7 3100. 0 1. 0 124. 0 25. 0 N o Improvemen t Informatio n Buildin g 1 3ei « N 2 2 a .
» 3 | f l T>( r

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f

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» E I ; Stor y CLIC KT O ENLARG E IMAG E Squar e Footage : 1127. 0 Percen t Complete : 100.0 % Perimete r 0. 0 Quality : Fai r Uni t Type : Condition : Poo r

Buil t As : 2 Stor y Cond o Squar e Footage : 0. 0 HVAC : Force d Ai r Rooms : 6. 0 Exterior : Fram e Sidin g Units : 1. 0 Interior : Drywal l Baths : 1. 0 Roo f Cover : Compositio n Shingl e Bedrooms : 3. 0

Roo fType : Gabl e Stories : 2. 0 Floorcover : Allowanc e Foundation : Bloc k Sprinkle rSquar e Footage : 0. 0 

### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.js p ?accountno=R20.. . 1/18/201 0

### Dougla s County Accoun t Intbmiatio n Pag e 3 o f 3

Yea rBuil t Yea r Remodele d 192 5 0 Detai l Typ e Applianc e Basemen t Fixtur e Fixtur e Garag e Porc h Porc h Percen t Remodele d 0 % Detai l Descriptio n Allowanc e Bsmn t Bloc k 8 ft Bas e Fixture s Bat h Ful l Detache d En d Scree n En d Scree n Adjuste d Yea r Buil t 192 5 Physica l Ag e 8 5 Unit s 1. 0 684. 0 1. 0 1. 0 440. 0 144. 0 25. 0



### http://douglasne.mapping-online.com/DouglasCoNe/static/accountinfo.jsp?accountno=R20. . . 1/18/201 0

### ENVIRONMENTA L AS-BUILTDRAWIN G ;MAH ALEA D SUPERFUN D SIT E RESTORATIO N

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